About the service: We carried out an unannounced comprehensive inspection of Stennards Leisure Retirement Home (Frankly Beeches) on 3 March 2019. Stennards Leisure Retirement Home (Frankly Beeches) is a ‘care home’ that provides care for a maximum of 18 older people. At the time of the inspection 17 people were using the service. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

People’s experience of using this service:

¿The management and staff at Stennards Leisure Retirement Home (Frankly Beeches) were highly committed to ensuring people lived fulfilling lives and were protected from social isolation. The whole focus of people's care was individualised and focused on promoting independence as well as their physical and mental well-being. They felt consulted and listened to about how their care would be delivered. People were empowered to make their own choices and decisions based on their individual ability and understanding. Staff were highly motivated with a 'can do' approach which meant they were able to achieve very positive outcomes for people.

¿The management team and staff knew people well and understood their likes and preferences and health needs. Staff were caring and spent time chatting with people as they moved around the service. Relatives told us they were welcome at any time and any concerns were taken seriously and responded to. Records showed the registered manager arranged to meet with people, and their relatives, privately to discuss any worries they might have.

¿People, relatives and staff gave us extremely positive feedback about the quality of people's care. Their comments were consistently positive and included, “An amazing place for [Relatives name]. They have come on leaps and bounds being here” and “There is always something going on and [relatives name] just loves getting involved. They [staff] really encourage it. Always a great atmosphere. Never a dull moment.”

¿People told us they felt safe. A relative told us, “It’s made such a difference to us just knowing [relative] is safe and well cared for here.” Staff demonstrated a good awareness of each person's safety and how to minimise risks for them. The environment was safe and people had access to appropriate mobility and moving and handling equipment needed. There was enough staff on duty at the right time to enable people to receive care in a timely way.

¿People were supported by staff who had the skills and knowledge to meet their needs. Staff understood and felt confident in their role. One said, “It’s a great staff team here. That’s why I came back. We are very well supported.”

¿People's health was well managed and staff had positive links with professionals which promoted wellbeing for them.

¿The registered manager used the same safe recruitment procedures we found at our last inspection.

¿Quality monitoring systems included audits, observation of staff practice and regular checks of the environment with examples of continuous improvements made in response to findings. People, their relatives and staff told us the registered provider was approachable, organised, listened and responded to them and acted on feedback.

More information is in Detailed Findings below

Rating at last inspection: The service was rated Good (report published 21 October 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. At our last inspection we rated the service Good. At this inspection we found the service had improved to outstanding under the responsive domain. The overall rating for this service is Good.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

We inspected this home on 23 August 2016. The home was last inspected in June 2015 and was meeting all the regulations. The home is registered to provide personal care and accommodation for up to 18 older people. At the time of our inspection 17 people were living at the home and one person was in hospital. We observed how care was provided to people and whether people were happy living at the home.

There was a registered manager in post who was present throughout the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

People and their relatives told us that they felt safe with the staff who supported them. Staff were aware of the need to keep people safe and understood their responsibilities to report allegations or suspicions of poor practice. Assessments had been undertaken to identify any potential risks to people and guidance was available for staff to follow to minimise those risks. Moving and handling transfers were not always carried out in a safe manner. Safe recruitment practices were in place. Medicines were being given as prescribed and stored safely.

Staff were provided with training to keep their knowledge and skills current. Staff told us that they had received a planned induction when they commenced working at the home. Staff’s knowledge and understanding of The Mental Capacity Act (2005) and Deprivation of Liberty Safeguards had improved. However, not all staff demonstrated the need to gain people’s consent to care and support before providing assistance. People were provided with a good choice of food and were supported to access relevant healthcare professionals when needed.

People were cared for by staff who knew them well and who they described as kind and compassionate. People expressed how they wanted their care to be delivered. People’s decisions and choices were respected by staff. People told us that they were treated with dignity and had their privacy respected.

People and their relatives had been involved in the development of their care plans but told us that they had not always contributed to the reviewing of their care needs. People were supported to participate in some social activities of their interests. People told us that they felt enabled to raise concerns and complaints and were confident that these would be investigated and acted upon.

People, their relatives and staff described the home as well-led and felt confident in the registered manager. People told us that they were asked their views about the care and support they received. There were systems in place to monitor and improve the quality and safety of the service provided.

We inspected this home on 24 June 2015. This was an unannounced inspection. The home provided care and accommodation for up to 18 older people, some of whom were living with dementia or who had additional mental health needs. Nursing care was not provided. The accommodation was provided in both single and shared bedrooms. On the day of our inspection there were 15 people living at the home.

The registered manager was present during our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

People told us they felt safe. Staff knew how to recognise when people might be at risk of harm and were aware of the provider’s procedures for reporting any concerns. There were systems and processes in place to protect people from harm.   

Pre-employment checks had been carried out for new members of staff; however more robust checking of references needed to be undertaken to check the validity of the people providing references to reduce the risk of unsuitable staff being employed by the service. These checks would ensure as far as possible that only people with the appropriate skills, experience and character are employed.

All the people, relatives and staff we spoke with told us they felt there were enough staff to meet people’s care needs. Staff had been trained to provide care and support and had been supported to obtain qualifications to enable them to ensure that care provided was safe and appropriate.   

People had received their medicines safely. We observed staff practising good medicine administration. We checked records and stocks of medicines and these suggested people had received their prescribed medicines as the doctor had prescribed. Most care plans for people contained guidelines and risk assessments to provide staff with information that would protect people from harm and keep them safe.  

People had regular access to a range of health care professionals which included general practitioners, district nurses, dentists, chiropodists and opticians. People’s nutritional and dietary needs had been assessed and people were supported to eat and drink sufficient amounts to maintain good health. People told us they had access to a variety of food and drink which they liked and enjoyed.

We looked at whether the home was applying safeguards appropriately to protect the legal rights of people living in the home. Whilst all staff had received training not all staff were confident about how they would comply with the law. We identified that one person might have been deprived of their liberty and no application had been submitted to the authorising body (Local Authority). The registered manager commenced action to ensure that the freedom of restriction for the person was referred for appropriate assessment in line with legislation.

People’s needs had been assessed and care plans developed to inform staff how to support people appropriately. Staff we spoke with demonstrated an understanding of people’s individual needs and preferences. They knew how people communicated their needs and if people needed support in certain areas of their life such as assistance with their personal care. We saw staff talking and listening to people in a caring and respectful manner.

People who lived in this home and where appropriate people’s relatives, told us that they were happy with the care provided and that people were treated with kindness, compassion and respect.    People knew how to raise complaints and the provider had arrangements in place so that people were listened to and action could be taken to make any necessary improvements.

The systems in place to monitor and improve the quality of the service were not always effective in ensuring the home consistently met the needs or expectations of the people living at the home .We found that some improvements were needed.

On the day of our visit, 17 people were living at this care home. We subsequently spoke to six people who use the service, four of their relatives and three members of care staff.

We found the home to be clean, homely and comfortable. Care was provided in an environment that was safe, accessible and adequately maintained.

People were complimentary about the care staff who supported them. Comments included,” We are very lucky, the staff are very good here.”

From our observations it was apparent that care staff were attentive, polite and sought consent before providing care and support. We spoke to relatives of people who lived at the home and they were equally complimentary about the staff and the care being provided. Comments included, “My relative has been here for two years and we are very happy with the care she receives."

We examined care plans and found that people’s needs were properly assessed and that care and treatment was planned and delivered in line with their individual care plans. People who used services had also given their consent to the care and support they received.

We found that this care home had an adequate complaints policy and that concerns were recorded and investigated competently.

We interviewed care staff and checked their personnel files and training records. We concluded that people who used services were safe and their health and welfare needs were being met by staff who were fit, appropriately qualified and competent.

During our visit, we observed the care and support being provided at the home and we talked with people about their experiences of the care at the home. We saw that staff supported people in a respectful manner. We saw that they greeted people by their preferred names and offered them choices of how and where they wanted to spend their time.

We spoke with eight people who lived at the home. People told us they were happy there. Comments from people who lived at the home included. ‘’It’s a good standard here’’ and ‘’They look after us.’’

We spoke with five relatives of people who lived at the home. They told us they were satisfied with the care provided. Relatives told us that people were always well groomed and that care workers looked after people well. One relative told us that one person used to have a lot of falls, but that these had been significantly reduced since they lived at the home. We spoke with one health care professional during our visit. They told us ‘’Staff are very good here with healthcare. They are always aware of people’s needs. If I ask them about people’s weight they always have a record. I have no concerns.’’

People’s privacy and dignity was respected. We found that staff spoke with people in a respectful manner and knocked on bedroom and bathroom doors before entering. One person who lived at the home told us ‘’ Staff always knock on my bedroom door before they come in.’’

At this visit, we spoke with people who lived at the home about staffing. People did not raise any concerns. One person told us ‘’Staff are good to me, they help me when I need them.’’